Patient education: Labor and delivery (childbirth) (The Basics)

Written by the doctors and editors at UpToDate
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Nov 24, 2016.

What happens during the delivery of a baby? — During delivery, the doctor or midwife will help you give birth to your baby. When a baby comes out of a woman’s vagina, it’s called a “vaginal delivery.” When a doctor does surgery to get a baby out of a woman’s uterus, it’s called a “c-section” or “cesarean delivery.”

During a vaginal delivery, you will work hard to push your baby out (figure 1). But before you can push your baby out, a few things need to happen. Your cervix has to soften, thin out, and open up all the way (figure 2). Also, your baby has to move down from the uterus into the vagina. When this happens, it can feel like you are going to have a bowel movement.

Your doctor or midwife will tell you when you can start pushing your baby out. In most cases, you can be in whatever position feels comfortable to you. For example, you can lie on your side, sit up, kneel, or squat. Pushing a baby out can take anywhere from minutes to hours. It usually takes longer when it’s a woman’s first baby.

Most mothers can push the baby out without any problems. But sometimes, the doctor or midwife will help get the baby out by pulling on a device that can be placed on the baby’s head. If the doctor needs to deliver a baby right away, he or she will do a c-section.

Does childbirth hurt? — Yes, childbirth usually hurts. But the amount of pain is different for each woman. Women choose to manage their pain in different ways. There is no one way that works for everyone. The right decision is the one that is best for you.

Some women choose to have a “natural” childbirth. This means that they do not use any pain medicines during labor or delivery. Instead, they do other things, such as breathing exercises, to lessen their pain.

Other women choose to have medicines to lessen the pain of labor and delivery. If you choose to have pain medicine, your doctor or midwife will probably start giving you the medicine during your labor, before delivery.

What if my baby is not in the right position? — Before birth, babies lie in the uterus in different positions (figure 3). At the end of pregnancy, most babies lie with their head closest to the vagina. But some babies lie with their legs, buttocks, or shoulders closest to the vagina. Doctors call it “breech” if a baby’s legs or buttocks are closest to the vagina.

If your baby isn’t facing head down, your doctor or midwife will talk with you about your options. He or she might be able to turn your baby before you go into labor and deliver him or her vaginally. Or he or she might suggest that you have a c-section.

What happens after I give birth? — After your baby is born, the placenta also needs to come out of the uterus. The placenta is the organ inside the uterus that brings a baby nutrients and oxygen, and carries away waste. Usually the placenta comes out naturally within 30 minutes of the baby’s birth, but sometimes the doctor or midwife has to help remove it from the uterus.

After the placenta is out of your uterus, the doctor or midwife will examine your vagina. If your skin tore during birth, you might need some stitches.

What happens to my baby after birth? — After birth, the doctor, nurse, midwife, or pediatrician will do a quick exam to check your baby’s body and general health. Part of this exam is called an “Apgar test.” It checks your baby’s heart rate, breathing, movement, muscles, and skin color. Your baby will get Apgar tests at 1 minute and 5 minutes after birth.

Soon after birth, you will be able to hold your baby. You can even breastfeed him or her, if you choose to breastfeed.

Your baby will get some treatments soon after birth. These include eye drops or an eye ointment to prevent an eye infection, and a dose of vitamin K to prevent abnormal bleeding.

Before your baby leaves the hospital, he or she will also have:

●A detailed physical exam

●A blood test (done by a heel prick) to check for different serious diseases that babies can be born with. For more information on this testing, ask your doctor or nurse.

●A hearing test

●A dose of the hepatitis B vaccine – Vaccines are treatments that can prevent certain serious infections. Hepatitis B is a serious liver infection.

When should I call the doctor or nurse after a vaginal delivery? — After you leave the hospital, call your doctor or nurse if you:

●Bleed a lot from your vagina – It is normal to have some vaginal bleeding for a few weeks after delivery. But let your doctor or nurse know if you are having large blood clots or your bleeding increases.

●Feel dizzy or faint

●Get a fever

●Vomit

●Have new belly pain

●Have a severe headache or problems with your vision

●Feel sad or helpless